This inspection took place on 14 and 15 August 2017 and was unannounced. Jubilee Lodge Centre provides accommodation for 74 people who require personal care with nursing. There were 72 people living in four households in the home at the time of our inspection. The home provided personal care and support for people with nursing needs; people who live with dementia and those who required a short period of recovery and therapy before they returned to their own home. People had access to quiet and well maintained accessible garden.

A registered manager was in place as required by their conditions of registration. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

People were cared for by staff who were passionate about improving people’s quality of life and who knew people well. People and their relatives praised the staff for their kindness and support. Staff supported people to attend health care appointments as required. The registered manager and staff had acted on people’s views and personal wishes to improve their life at Jubilee Lodge. People enjoyed the meals provided. They were being consulted about their likes and dislikes

People’s rights were protected. They were supported to make decisions about their care and support. People’s care records provided staff with detailed information about their support needs, personal histories and social interests. Their individual risks had been identified and assessed. Whilst staff supported people to minimise their risks, there was not always clear recorded guidance for staff to follow.

The registered manager and provider were actively recruiting new staff to ensure people were being cared for by a consistent and familiar team. The management and administration of their medicines was based on people’s individual support needs. The managers had taken action to address previous errors in the management of people’s medicines.

People benefited from staff who had been trained and supported to carry out their role. Staff understood their responsibility to safeguard people and report any concerns. Plans were in place to implement and monitor the system to support staff. A clear recruitment process was in place to ensure people were supported by staff of good character. However conversations about any discrepancies in their employment histories were not always recorded.

The registered manager had a good understanding of their role and how to manage the quality of the care provided to people. Quality monitoring systems were developed to check and address any shortfalls in the service; however the systems did not always monitor the skills of nurses and senior staff and the recruitment processes of staff. Where concerns had been raised by people and their relatives these had been addressed immediately.

This inspection took place on 16 and 17 June 2016 and was unannounced. Jubilee Lodge Centre provides accommodation for 74 people who require personal care with nursing. There were 71 people were living in the home at the time of our inspection. The home provided personal care and support for people with nursing needs; people who live with dementia and those who required a short period of recovery and therapy before they returned to their own home.

Jubilee Lodge is a purpose built home set over two floors and divided into four units known as households. Each household has a small kitchen and adjacent dining room and a variety of lounges and quite areas to sit in. The home had a shop, activities room and hairdressers.

A registered manager was in place as required by their conditions of registration. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

People and their relatives were positive about the care they received and felt safe. There were caring and friendly interactions between staff and people. Relatives felt welcomed at any time and could take part in the home’s activities.

People were being supported by suitable numbers of trained staff. Staff had been trained in understanding their responsibilities in reporting any allegations or incidents of abuse. Staff were knowledgeable about people’s physical, mental and emotional needs. People’s risks had been assessed and monitored by staff. They were referred to external health care services if there were changes in their wellbeing. The management and administration of people’s medicines was based on their individual support needs. People enjoyed the meals provided. They were encouraged to eat and drink. People’s specialist diets were catered for.

People’s support plans included information about how they preferred to be supported. Staff were knowledgeable about their needs, wishes and preferences. However, the details of the lawful consent to receive care were not always evident when people could not make a decision about their care and support for themselves. They received care which reflected their individual preferences and routines. Staff had a good understanding of their personal histories and knew people well. However, some people’s care plans had not been updated to reflect their needs. People’s daily notes were variable and often focused on tasks rather than people’s well-being. However, staff were knowledgeable about people’s risks, changes in their needs and support requirements.

Staff listened and acted on people’s concerns. Events and information about the home was shared with people and their relatives. People’s recreational and social needs were met. They enjoyed activities in the home as well as places of interest in the local area.

Systems were in place to ensure people were supported by staff who had been supported to carry out their role. Their previous employment history and background had been checked. Staff said they felt supported and could raise concerns with the registered manager. The registered manager had a good understanding of their role. They provided support to staff to ensure people’s health needs were being monitored. Quality monitoring systems were in place to check and address any shortfalls in the service. Where concerns had been raised by people and their relatives these had been addressed immediately.

We carried out an announced comprehensive inspection of this service on 5 August 2014. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 relating to people’s care records

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Jubilee Lodge on our website at www.cqc.org.uk.

At this inspection we found the support and care provided was now responsive to people’s care needs. The layout and detail of people’s care records had been reviewed and updated. People’s risks were clearly been monitored and recorded. This gave staff with sufficient information to guide them on how best to deliver care that was centred on people’s needs and helped to reduce risks. Where possible people had been involved in their care planning.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

A registered manager was in place as required by their conditions of registration. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. The registered manager was present during our inspection.

Jubilee Lodge is a home that provides care for up to 74 people who have nursing needs; live with a type of dementia or need a period of time to recover and rehabilitate from an illness. At the time of our inspection 71 people were using the service. This was an unannounced inspection.

This service was last inspected on 10 and 11 July 2013 when it met all the legal requirements and regulations associated with the Health and Social care Act 2008.

People’s needs had been assessed and reviewed however the monitoring of some people’s individual risks had not always been recorded. This is a breach of Regulation 20 Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

Staff were sensitive to people’s needs and treated them with kindness and respect . Volunteers helped staff by providing individual activities and social time for people who were unable to take part in group activities. Activities were provided to the majority of people but some people who were staying in the home for a short period of time were not always offered activities.

Staff were supported and trained to carry out their role. The head nurse and qualified nurses were supported by enhanced trained unit leads. This allowed the nurses to carry out a clinical role and support people with more medical and health care needs. People were encouraged to maintain a healthy diet and lifestyle. They were referred to the appropriate health and social care professionals to be reassessed if their needs had changed. However a health care professional was concerned that the unit leads did not always immediately recognise a change in people’s health.

People were given a choice of food though some had mixed feelings about the quality of food. There was an sometimes an inconsistent approach to providing some people with a diet that suited their needs.

People were supported by sufficient numbers of staff who had been trained, supported and suitably recruited to ensure they had the skills to support people who were living in the home.

Staff understood the need to protect people from abuse and harm. They recognised that people had a right to make choices about their care. Where people were unable to express their views staff supported them to make best interest decisions about their care and day to day activities.

The registered manager knew their role and responsibilities in protecting people in the least restrictive way and reporting any safeguarding concerns to the relevant authorities.

Quality assurance systems had been established which involved people and their relatives. People were encouraged to express their views and concerns. They felt that they would be listened to and their concerns would be acted upon. People and their relatives were encouraged to feedback suggestions about the home. The registered manager had responded to people’s views and had started to make improvements around the home and gardens. People, relatives and staff complimented the improvement in the quality of care and home’s environment.

We spoke to six people who were using the service. Generally we heard positive comments about the service provided such as, "you couldn't get treated better" and "very good". People we spoke to told us that the staff treated them politely and respected their privacy. We used an observation tool in the dementia care unit and found that people there were treated respectfully by staff. We found that there were systems in place to assess and plan care for people to meet their needs. People also told us that they received enough help to meet their needs.

Staff had received training to safeguard people from abuse and people we spoke to who used the service confirmed that Jubilee Lodge was a safe place to be. We found that there were arrangements to provide enough staff to meet people's needs. When we asked people about how staff responded when they used the call bell, one person using the re-enablement unit told us, "always somebody comes". We found that there were systems in place to monitor the quality of the service provided to people.